Medications for mental illness
Psychotropic medications are used to treat the symptoms of mental illness. Those that play an important role in the treatment and management of psychotic disorders and comorbid psychiatric conditions include:- antipsychotics used either orally or in an injectable (short or long-acting) form to control the acute symptoms of psychosis and prevent relapse
- antidepressants used to treat depression which may be an early feature of psychosis or a secondary feature arising in the context of psychosis, as in ICD-10 post-psychotic depression
- mood stabilisers used to treat mania, including bipolar disorder, and to prevent relapse; they may also be used for treatment-resistant depression or as an adjunct to antipsychotic medications
- anxiolytics, hypnotics and sedatives used to treat common and non-specific symptoms, such as anxiety, insomnia and restlessness; or used as an adjunct to antipsychotic medication to ameliorate the symptoms of acute psychosis; and
- anticholinergics used to reduce neuromuscular side effects, such as Parkinson-like movement disorders, associated with the use of antipsychotic medication, particularly typical antipsychotics.
Typical and atypical antipsychotics are effective in reducing the positive symptoms of psychosis, but are less effective in ameliorating negative symptoms. In general, atypical antipsychotics are less likely to produce neuromuscular side effects (for example, Parkinson-like movement disorders) than typical antipsychotics. However, they have also been associated with weight gain and consequent risk of poor physical health outcomes, especially metabolic disorders such as diabetes type 2.
Clozapine, an early atypical antipsychotic, is often used in cases of treatment-resistant schizophrenia, that is cases that do not respond to other antipsychotic medications.
Appendix Table 15-1. Prescribed medication used in past 4 weeks
Males (%) | Females (%) | 18-34 years (%) | 35-64 years (%) | Persons (%) | |||
---|---|---|---|---|---|---|---|
Medications for mental health | |||||||
Atypical antipsychotics: All | 76.3 | 70.7 | 75.2 | 73.2 | 74.0 | ||
Atypical antipsychotics: Clozapine | 19.9 | 11.4 | 16.2 | 16.6 | 16.4 | ||
Typical antipsychotics | 16.0 | 14.1 | 12.5 | 17.2 | 15.2 | ||
Antidepressants | 32.5 | 44.7 | 31.7 | 41.6 | 37.4 | ||
Mood stabilisers | 24.5 | 30.1 | 22.3 | 30.0 | 26.7 | ||
Anxiolytics, hypnotics, sedatives | 15.7 | 20.7 | 15.1 | 19.7 | 17.8 | ||
Anticholinergics | 4.7 | 3.4 | 3.6 | 4.6 | 4.2 | ||
Alcohol/Nicotine/Opoid dependence | 4.0 | 2.8 | 4.5 | 2.8 | 3.5 | ||
Subtotal on antipsychotics | 84.4 | 77.6 | 80.6 | 82.4 | 81.6 | ||
Total in past 4 weeks | 91.4 | 91.9 | 88.6 | 93.8 | 91.6 | ||
Total in past year | 94.1 | 94.7 | 93.5 | 95.0 | 94.4 | ||
Medications for physical conditions | |||||||
Cardiovascular | 17.1 | 19.8 | 7.4 | 26.1 | 18.2 | ||
Endocrine: Any | 10.2 | 21.4 | 7.2 | 20.2 | 14.7 | ||
Endocrine: For diabetes | 7.7 | 8.8 | 3.1 | 11.9 | 8.2 | ||
Gastrointestinal | 11.5 | 14.8 | 6.9 | 17.2 | 12.8 | ||
Respiratory | 4.6 | 8.0 | 4.3 | 7.2 | 6.0 | ||
Blood and electrolytes | 3.4 | 4.9 | 1.8 | 5.6 | 4.0 | ||
Neurological | 3.4 | 4.3 | 2.8 | 4.5 | 3.8 | ||
Musculoskeletal | 3.2 | 4.5 | 1.7 | 5.2 | 3.7 | ||
Genitourinary | 0.7 | 0.8 | 0.3 | 1.1 | 0.8 | ||
Total in past 4 weeks | 38.5 | 45.0 | 27.8 | 50.9 | 41.1 | ||
Median number of prescribed medications (if using) | 2 | 3 | 2 | 3 | 3 | ||
Non-prescribed supplements for mental health Proportion taking supplements for mental health | 20.1 | 24.5 | 20.4 | 23.0 | 21.9 |
* Unless otherwise indicated, these numbers relate to prescribed medication use in the past four weeks
Top of pageAppendix Table 15-2. Impairments due to medication prescribed for mental health in past 4 weeks
Males (%) | Females (%) | 18-34 years (%) | 35-64 years (%) | Persons (%) | ||||
---|---|---|---|---|---|---|---|---|
Any medication side effects | 76.6 | 78.5 | 75.9 | 78.4 | 77.4 | |||
Moderate/severe impairment in daily life due to medication side effects | 30.0 | 29.8 | 29.4 | 30.3 | 29.9 |
Appendix Table 15-3. Side effects attributed to medication prescribed for mental health in past 4 weeks
Males (%) | Females (%) | 18-34 years (%) | 35-64 years (%) | Persons (%) | |||
---|---|---|---|---|---|---|---|
Drowsiness,sleepiness during the day | 43.4 | 46.6 | 45.0 | 44.5 | 44.7 | ||
Mouth dry or more watery than normal | 37.4 | 42.5 | 34.3 | 43.3 | 39.5 | ||
Increase in weight | 33.1 | 44.0 | 39.5 | 36.1 | 37.5 | ||
Inner restlessness | 26.5 | 24.7 | 24.3 | 26.8 | 25.8 | ||
Trembling, shaking hand/arm/leg | 22.8 | 25.6 | 21.2 | 26.0 | 23.9 | ||
Inability to relax | 21.5 | 19.6 | 18.9 | 22.1 | 20.8 | ||
Inability to stand still, desire to move legs, pacing | 19.1 | 19.6 | 19.4 | 19.3 | 19.3 | ||
Stiff, tensed muscles | 18.3 | 20.1 | 16.6 | 20.8 | 19.0 | ||
Increased dreaming | 17.6 | 20.2 | 19.0 | 18.3 | 18.6 | ||
Dizziness or vertigo | 16.7 | 21.5 | 16.0 | 20.5 | 18.6 | ||
Trouble with eyesight | 16.0 | 18.8 | 13.3 | 20.0 | 17.2 | ||
Unsteady when standing or walking | 15.2 | 19.1 | 14.2 | 18.6 | 16.8 | ||
Slowing down of movements | 15.5 | 17.8 | 14.2 | 18.1 | 16.4 | ||
Change of interest in sex | 16.9 | 15.2 | 15.8 | 16.5 | 16.2 | ||
Nauseous/Feeling sick | 14.4 | 18.3 | 16.2 | 15.8 | 15.9 | ||
Constipation | 13.9 | 18.7 | 12.9 | 18.0 | 15.8 | ||
Increased sweating | 14.8 | 15.6 | 13.8 | 16.1 | 15.1 | ||
Period pain or change in frequency (Females only) | - | 12.2 | 14.6 | 10.9 | 12.2 | ||
Palpitations | 9.8 | 14.9 | 10.3 | 12.9 | 11.8 | ||
Difficulty swallowing | 10.2 | 12.7 | 9.3 | 12.6 | 11.2 | ||
Sexual dysfunction | 10.2 | 10.6 | 9.7 | 10.8 | 10.4 | ||
Shuffling along | 7.8 | 6.2 | 5.2 | 8.7 | 7.2 | ||
Skin rashes | 6.3 | 8.4 | 5.2 | 8.6 | 7.1 | ||
Unwanted tongue movement | 7.3 | 6.5 | 5.7 | 7.9 | 7.0 | ||
Swollen tender chest | 2.9 | 4.6 | 3.2 | 3.8 | 3.6 | ||
Decrease in weight | 3.2 | 3.4 | 2.8 | 3.6 | 3.3 |
Appendix Table 15-4. Weight gain in past 6 months related to use of medication for mental health
Males | Females | 18-34 years | 35-64 years | Persons | |
---|---|---|---|---|---|
Mean | 10 | 9 | 10 | 9 | 9 |
Median | 8 | 8 | 10 | 8 | 8 |
Appendix Table 15-5. Relief from mental health symptoms due to medication use
Males (%) | Females (%) | 18-34 years (%) | 35-64 years (%) | Persons (%) | ||
---|---|---|---|---|---|---|
A lot | 56.7 | 58.0 | 53.7 | 59.7 | 57.2 | |
A little | 28.3 | 28.0 | 32.1 | 25.4 | 28.2 | |
Not at all | 10.4 | 8.4 | 9.5 | 9.6 | 9.6 | |
Not known | 4.6 | 5.6 | 4.7 | 5.3 | 5.0 | |
Total of those using medications | 994 | 678 | 685 | 987 | 1672 |
Appendix Table 15-6. Psychosocial interventions in past year
Males (%) | Females (%) | 18-34 years (%) | 35-64 years (%) | Persons (%) | |||
---|---|---|---|---|---|---|---|
Counselling, psychotherapy or group therapy | 26.0 | 37.1 | 30.7 | 30.4 | 30.5 | ||
Cognitive behavioural therapy | 18.1 | 28.5 | 24.6 | 20.6 | 22.3 | ||
Family intervention | 11.1 | 11.8 | 14.4 | 9.2 | 11.4 |